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Mendez MF. The Implications of Moral Neuroscience for Brain Disease: Review and Update. Cogn Behav Neurol 2023; 36:133-144. [PMID: 37326483 DOI: 10.1097/wnn.0000000000000344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/06/2023] [Indexed: 06/17/2023]
Abstract
The last 2 decades have seen an explosion of neuroscience research on morality, with significant implications for brain disease. Many studies have proposed a neuromorality based on intuitive sentiments or emotions aimed at maintaining collaborative social groups. These moral emotions are normative, deontological, and action based, with a rapid evaluation of intentionality. The neuromoral circuitry interacts with the basic mechanisms of socioemotional cognition, including social perception, behavioral control, theory of mind, and social emotions such as empathy. Moral transgressions may result from primary disorders of moral intuitions, or they may be secondary moral impairments from disturbances in these other socioemotional cognitive mechanisms. The proposed neuromoral system for moral intuitions has its major hub in the ventromedial prefrontal cortex and engages other frontal regions as well as the anterior insulae, anterior temporal lobe structures, and right temporoparietal junction and adjacent posterior superior temporal sulcus. Brain diseases that affect these regions, such as behavioral variant frontotemporal dementia, may result in primary disturbances of moral behavior, including criminal behavior. Individuals with focal brain tumors and other lesions in the right temporal and medial frontal regions have committed moral violations. These transgressions can have social and legal consequences for the individuals and require increased awareness of neuromoral disturbances among such individuals with brain diseases.
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Affiliation(s)
- Mario F Mendez
- Departments of Neurology
- Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- Neurology Service, Neurobehavior Unit, V.A. Greater Los Angeles Healthcare System, Los Angeles, California
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2
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Mendez MF. Culpability for offenses in frontotemporal dementia and other brain disorders. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 89:101909. [PMID: 37467544 DOI: 10.1016/j.ijlp.2023.101909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/23/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
The responsibility of persons with brain disorders who commit offenses may depend on how their disorders alter brain mechanisms for culpability. Criminal behavior can result from brain disorders that alter social cognition including a neuromoral system of intuitive moral emotions that are absolute (deontological) normative codes and that includes an emotion-mediated evaluation of intentionality. This neuromoral system has its hub in the ventromedial prefrontal cortex (VMPFC) with other frontal, anterior temporal-amygdalar, insular, and right temporoparietal connections. Among brain disorders, investigators report offenses in persons with brain tumors, epilepsy, and traumatic brain injury, but it is those with a form of dementia with VMPFC pathology, behavioral variant frontotemporal dementia (bvFTD), who are most prone to criminal behavior. This review presents four new patients with bvFTD who were interviewed after committing offenses. These patients knew the nature of their acts and the wrongness of the type of action but lacked substantial capacity to experience the criminality of their conduct at the intuitive, deontological, moral emotional level. Disease in VMPFC and its amygdalar connections may impair moral emotions in these patients. These findings recommend evaluation for the experience of moral emotions and VMPFC-amygdala dysfunction among persons with antisocial behavior, with or without brain disease.
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Affiliation(s)
- Mario F Mendez
- Departments of Neurology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, and Neurology Service, Neurobehavior Unit, Los Angeles, CA, United States; U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, United States.
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3
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Tonnaer F, van Zutphen L, Raine A, Cima M. Amygdala connectivity and aggression. HANDBOOK OF CLINICAL NEUROLOGY 2023; 197:87-106. [PMID: 37633721 DOI: 10.1016/b978-0-12-821375-9.00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
Neurobiological models propose that reactive aggression is predicated on impairments in amygdala-prefrontal connectivity that subserves moral decision-making and emotion regulation. The amygdala is a key component within this neural network that modulates reactive aggression. We provide a review of amygdala dysfunctional brain networks leading to reactive aggressive behavior. We elaborate on key concepts, focusing on moral decision-making and emotion regulation in a developmental context, and brain network connectivity factors relating to amygdala (dys)function-factors which we suggest predispose to reactive aggression. We additionally discuss insights into the latest treatment interventions, providing the utilization of the scientific findings for practice.
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Affiliation(s)
- Franca Tonnaer
- Department of Research, Ventio Crime Prevention Science Institute, Rijckholt, The Netherlands
| | - Linda van Zutphen
- Department of Conditions for LifeLong Learning, Educational Sciences, Open University, Heerlen, The Netherlands
| | - Adrian Raine
- Department of Criminology, Richard Perry University, Berkeley, CA, United States; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Maaike Cima
- Department of Research, Ventio Crime Prevention Science Institute, Rijckholt, The Netherlands; Department of Developmental Psychopathology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Department of Research, VIGO Groep, Nijmegen, The Netherlands.
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4
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Magrath Guimet N, Zapata-Restrepo LM, Miller BL. Advances in Treatment of Frontotemporal Dementia. J Neuropsychiatry Clin Neurosci 2022; 34:316-327. [PMID: 35578801 DOI: 10.1176/appi.neuropsych.21060166] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this review, the authors explored the clinical features of frontotemporal dementia (FTD), focusing on treatment. The clinical features of FTD are unique, with disinhibition, apathy, loss of empathy, and compulsions common. Motor changes occur later in the illness. The two major proteins that aggregate in the brain with FTD are tau and TDP-43, whereas a minority of patients aggregate FET proteins, primarily the FUS protein. Genetic causes include mutations in MAPT, GRN, and C9orf72. There are no medications that can slow FTD progression, although new therapies for the genetic forms of FTD are moving into clinical trials. Once a diagnosis is made, therapies should begin, focusing on the family and the patient. In the setting of FTD, families experience a severe burden associated with caregiving, and the clinician should focus on alleviating this burden. Advice around legal and financial issues is usually helpful. Careful consideration of environmental changes to cope with abnormal behaviors is essential. Most compounds that have been used to treat dementia of the Alzheimer's disease type are not effective in FTD, and cholinesterase inhibitors and memantine should be avoided. Although the data are scant, there is some evidence that antidepressants and second-generation antipsychotics may help individual patients.
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Affiliation(s)
- Nahuel Magrath Guimet
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Lina M Zapata-Restrepo
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco (all authors); Institute of Neuroscience, Trinity College, Dublin (all authors); Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires (Magrath Guimet); Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco (Miller); and Department of Medical Sciences, Pontifical Xaverian University Cali, Cali, Colombia (Zapata-Restrepo), Department of Psychiatry, Fundación Valle del Lili, Cali, Colombia (Zapata-Restrepo)
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Ivascu L, Pavel CD, Sarfraz M, Arulanandam BV, Tan HY. An Exploratory Study on Corporate Governance From Neuro-Governance Lenses in the Malaysian Context. Front Psychol 2022; 13:911907. [PMID: 35783779 PMCID: PMC9241444 DOI: 10.3389/fpsyg.2022.911907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Our minds are powerful, creative, forceful, and strong, controlling our thinking and behaviors. A series of high-profile accounting and financial scandals have been revealed in the past few decades, and the Enron case was the most representative of them all. Corporate decision-makers have traditionally enjoyed high remunerations, compensations, and social status. Hence, the underlying rationales and motivation drivers that motivate managers to conduct unethical behaviors have always been a heightened concern. This research aims to delineate the narratives of corporate governance misconducts and the underlying rationales of these unethical behaviors. This study incorporates independent variables of neuro-accounting, neuroeconomics, neuro-ethics, and human nature using a qualitative methodology. From this study, the social norm of fairness showed that the human nature of greed and selfishness would motivate corporate decision-makers to engage in any exchange that could benefit themselves, although it is unethical and illegal. Second, neuroeconomics revealed that scarcity of economic resources, level of risks and uncertainties, and expected rewards could be the factors that motivate managers to conduct unethical behaviors, especially when their remunerations are tightly linked to company performances. Third, neuro-ethics shows that managers who lack moral values, have unstable emotions, and possess negative moral intuitions or personal assumptions could be more likely to pursue their interests at the cost of others. Lastly, neuro-governance also proved that self-benefits and financial incentives will usually be the priority and would be a motivating factor for misconduct.
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Affiliation(s)
- Larisa Ivascu
- Faculty of Management in Production and Transportation, Politehnica University of Timişoara, Timişoara, Romania
- Academy of Romanian Scientists, Bucharest, Romania
| | - Codruta Daniela Pavel
- Faculty of Economics and Business Administration, West University of Timişoara, Timişoara, Romania
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Luis EO, Akrivou K, Bermejo-Martins E, Scalzo G, Orón JV. The Interprocessual-Self Theory in Support of Human Neuroscience Studies. Front Psychol 2022; 12:686928. [PMID: 35153881 PMCID: PMC8832125 DOI: 10.3389/fpsyg.2021.686928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Rather than occurring abstractly (autonomously), ethical growth occurs in interpersonal relationships (IRs). It requires optimally functioning cognitive processes [attention, working memory (WM), episodic/autobiographical memory (AM), inhibition, flexibility, among others], emotional processes (physical contact, motivation, and empathy), processes surrounding ethical, intimacy, and identity issues, and other psychological processes (self-knowledge, integration, and the capacity for agency). Without intending to be reductionist, we believe that these aspects are essential for optimally engaging in IRs and for the personal constitution. While they are all integrated into our daily life, in research and academic work, it is hard to see how they are integrated. Thus, we need better theoretical frameworks for studying them. That study and integration thereof are undertaken differently depending on different views of what it means to live as a human being. We rely on neuroscientific data to support the chosen theory to offer knowledge to understand human beings and interpersonal relational growth. We should of course note that to describe what makes up the uniqueness of being, acting, and growing as a human person involves something much more profound which requires too, a methodology that opens the way for a theory of the person that responds to the concerns of philosophy and philosophical anthropology from many disciplines and methods (Orón Semper, 2015; Polo, 2015), but this is outside the scope of this study. With these in mind, this article aims to introduce a new explanatory framework, called the Interprocessual-self (IPS), for the neuroscientific findings that allow for a holistic consideration of the previously mentioned processes. Contributing to the knowledge of personal growth and avoiding a reductionist view, we first offer a general description of the research that supports the interrelation between personal virtue in IRs and relevant cognitive, emotional, and ethic-moral processes. This reveals how relationships allow people to relate ethically and grow as persons. We include conceptualizations and descriptions of their neural bases. Secondly, with the IPS model, we explore neuroscientific findings regarding self-knowledge, integration, and agency, all psychological processes that stimulate inner exploration of the self concerning the other. We find that these fundamental conditions can be understood from IPS theory. Finally, we explore situations that involve the integration of two levels, namely the interpersonal one and the social contexts of relationships.
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Affiliation(s)
- Elkin O. Luis
- Psychological Processes in Education and Health Group, School of Education and Psychology, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Kleio Akrivou
- Henley Business School, University of Reading, Reading, United Kingdom
| | - Elena Bermejo-Martins
- Navarra Institute for Health Research, Pamplona, Spain
- Department of Community Nursing and Midwifery, School of Nursing, University of Navarra, Pamplona, Spain
| | - Germán Scalzo
- School of Business, Universidad Panamericana, Mexico City, Mexico
| | - José Víctor Orón
- Fundación UpToYou Educación, Zaragoza, Spain
- *Correspondence: José Víctor Orón,
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Magrath Guimet N, Miller BL, Allegri RF, Rankin KP. What Do We Mean by Behavioral Disinhibition in Frontotemporal Dementia? Front Neurol 2021; 12:707799. [PMID: 34305805 PMCID: PMC8292604 DOI: 10.3389/fneur.2021.707799] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
Behavioral variant frontotemporal dementia, unlike other forms of dementia, is primarily characterized by changes in behavior, personality, and language, with disinhibition being one of its core symptoms. However, because there is no single definition that captures the totality of behavioral symptoms observed in these patients, disinhibition is an umbrella term used to encompass socially disruptive or morally unacceptable behaviors that may arise from distinct neural etiologies. This paper aims to review the current knowledge about behavioral disinhibition in this syndrome, considering the cultural factors related to our perception of behavior, the importance of phenomenological interpretation, neuroanatomy, the brain networks involved and, finally, a new neuroscientific theory that offers a conceptual framework for understanding the diverse components of behavioral disinhibition in this neurodegenerative disorder.
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Affiliation(s)
- Nahuel Magrath Guimet
- Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires, Argentina
| | - Bruce L Miller
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.,Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Ricardo F Allegri
- Department of Cognitive Neurology, Neuropsychiatry and Neuropsychology, Instituto Neurológico Fleni, Buenos Aires, Argentina.,Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
| | - Katherine P Rankin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
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Ziaei M, Togha M, Rahimian E, Persson J. The Causal Role of Right Frontopolar Cortex in Moral Judgment, Negative Emotion Induction, and Executive Control. Basic Clin Neurosci 2019; 10:37-48. [PMID: 31031892 PMCID: PMC6484187 DOI: 10.32598/bcn.9.10.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 08/05/2017] [Accepted: 12/04/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction: Converging evidence suggests that both emotional and cognitive processes are critically involved in moral judgment, and may be mediated by discrete parts of the prefrontal cortex. The current study aimed at investigating the mediatory effect of right Frontopolar Cortex (rFPC) on the way that emotions affect moral judgments. Methods: Six adult patients affected by rFPC and 10 healthy controls were included in the study. Participants made judgements on moral dilemmas after being shown either neutral or emotional pictures. The role of rFPC in executive control and emotional experience was also examined. Results: The study results showed that inducing an emotional state increased the number of utilitarian responses both in the patients and controls. However, no significant differences were observed between the patients and controls in response time or the number of utilitarian responses. Also, no significant differences were observed in personal and impersonal dilemmas before and after the emotion induction in intergroup comparisons. Results of the executive control tasks showed reduced performance in patients affected by rFPC compared with the controls. Conclusion: The results of the current study suggested that rFPC might not have a direct role in mediating emotional processes during moral judgments, but possibly this region is important in a network supporting executive control functions.
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Affiliation(s)
- Maryam Ziaei
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia.,School of Psychology, The University of Queensland, Brisbane, Australia
| | - Mansoureh Togha
- Department of Headache, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Jonas Persson
- Aging Research Center (ARC), Karolinska Institute and Stockholm University, Stockholm, Sweden
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Koelkebeck K, Kuegler L, Kohl W, Engell A, Lencer R. Social cognition in schizophrenia: The role of mentalizing in moral dilemma decision-making. Compr Psychiatry 2018; 87:171-178. [PMID: 30415199 DOI: 10.1016/j.comppsych.2018.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/02/2018] [Accepted: 10/28/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Patients with schizophrenia have difficulties in several aspects of social cognition, e.g. emotion recognition and mentalizing. It is yet unclear if patients also show deficits in moral decision-making and whether the two aspects interact. Deficits in moral decision-making abilities might put patients in disadvantageous positions in every-day interactions. METHOD Twenty-five patients with schizophrenia and twenty-five matched healthy controls participated in six moral dilemma tasks, a standard moral competency test and two mentalizing tasks. In addition, we assessed psychopathology and empathy abilities. In a brief intervention patients were asked to empathize with characters in the moral dilemmas. We expected that the decisions made by patients with schizophrenia would be more out-come-oriented, i.e. utilitarian, as compared to those made by healthy controls. RESULTS Patients and healthy controls did not decide significantly differently on the moral dilemmas and patients showed normal moral competencies. Deficits in mentalizing in patients were replicated. Only in a regression analysis, however, we were able to show that PANSS positive scores and the Comic Strip task scores contributed to the moral decisions. Empathy training did not have an altering influence on decision-making. DISCUSSION Although an overlap between social cognition and moral decision-making networks has been proposed, deficits in moral decision-making and explicit associations with mentalizing were not present in patients. Psychopathology together with mentalizing abilities, however, contributed to decision-making in patients. Our findings suggest that in schizophrenia some aspects, e.g. mentalizing, are more strongly impaired while other aspects, e.g. moral decision-making, are preserved. Further research is needed to elucidate the different aspects forming social cognition and their mutual contributions, specifically in schizophrenia.
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Affiliation(s)
- Katja Koelkebeck
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Lisa Kuegler
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Waldemar Kohl
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Alva Engell
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
| | - Rebekka Lencer
- University of Muenster, School of Medicine, Department of Psychiatry and Psychotherapy, Muenster, Germany.
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Santamaría-García H, Reyes P, García A, Baéz S, Martinez A, Santacruz JM, Slachevsky A, Sigman M, Matallana D, Ibañez A. First Symptoms and Neurocognitive Correlates of Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2018; 54:957-970. [PMID: 27567867 DOI: 10.3233/jad-160501] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD). However, little is known regarding how the early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease's clinical presentation at future stages of disease. OBJECTIVES We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease. METHODS We evaluated the neuropsychological, clinical, and neuroanatomical (3T structural images) correlates in a group of healthy controls (n = 30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n = 18] or disinhibition [DbvFTD, n = 16]). To differentiate groups according to first symptoms, we used multivariate analyses. RESULTS The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular, and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula, and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal, and left caudate were enough to distinguish the patients' subgroups.∥Conclusion: First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments.
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Affiliation(s)
- Hernando Santamaría-García
- Pontificia Universidad Javeriana Bogotá, Colombia.,Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Intellectus, Memory and cognition center. Hospital San Ignacio Bogotá, Colombia
| | - Pablo Reyes
- Pontificia Universidad Javeriana Bogotá, Colombia.,Intellectus, Memory and cognition center. Hospital San Ignacio Bogotá, Colombia
| | - Adolfo García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Nacional de Cuyo (UNCuyo), Facultad de Educación Elemental y Especial (FEEyE), Mendoza, Argentina
| | - Sandra Baéz
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Angela Martinez
- Pontificia Universidad Javeriana Bogotá, Colombia.,Université Lumière Lyon 2 - Laboratoire Dynamique du langage, Lyon, France
| | - José Manuel Santacruz
- Pontificia Universidad Javeriana Bogotá, Colombia.,Intellectus, Memory and cognition center. Hospital San Ignacio Bogotá, Colombia.,Departament de Psiquiatria i medicina legal. Universitat Autónoma de Barcelona, Cerdanyola del Vallés, España
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism, Avenida Salvador 486, Providencia, Santiago, Chile.,Physiopathology Department, ICBM y East Neuroscience Department, Faculty of Medicine, Universidad de Chile, Avenida Salvador 486, Providencia, Santiago, Chile.,Cognitive Neurology and Dementia Unit, Neurology Department, Hospital del Salvador, Av. Salvador 364, Providencia, Santiago, Chile.,Center for Advanced Research in Education (CIAE), Universidad de Chile, 8330014, Santiago, Chile.,Neurology Department, Clínica Alemana, Santiago, Chile
| | - Mariano Sigman
- Universidad Torcuato di Tella Laboratorio de Neurociencias, Buenos Aires, Argentina
| | - Diana Matallana
- Pontificia Universidad Javeriana Bogotá, Colombia.,Intellectus, Memory and cognition center. Hospital San Ignacio Bogotá, Colombia.,Instituto de envejecimiento. Pontificia Universidad Javeriana, Colombia
| | - Agustín Ibañez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile.,Universidad Autónoma del Caribe, Barranquilla, Colombia.,Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), NSW, Australia
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11
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Van den Stock J, Stam D, De Winter F, Mantini D, Szmrecsanyi B, Van Laere K, Vandenberghe R, Vandenbulcke M. Moral processing deficit in behavioral variant frontotemporal dementia is associated with facial emotion recognition and brain changes in default mode and salience network areas. Brain Behav 2017; 7:e00843. [PMID: 29299378 PMCID: PMC5745238 DOI: 10.1002/brb3.843] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/10/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction Behavioral variant frontotemporal dementia (bvFTD) is associated with abnormal emotion recognition and moral processing. Methods We assessed emotion detection, discrimination, matching, selection, and categorization as well as judgments of nonmoral, moral impersonal, moral personal low- and high-conflict scenarios. Results bvFTD patients gave more utilitarian responses on low-conflict personal moral dilemmas. There was a significant correlation between a facial emotion processing measure derived through principal component analysis and utilitarian responses on low-conflict personal scenarios in the bvFTD group (controlling for MMSE-score and syntactic abilities). Voxel-based morphometric multiple regression analysis in the bvFTD group revealed a significant association between the proportion of utilitarian responses on personal low-conflict dilemmas and gray matter volume in ventromedial prefrontal areas (pheight < .0001). In addition, there was a correlation between utilitarian responses on low-conflict personal scenarios in the bvFTD group and resting-state fractional Amplitude of Low Frequency Fluctuations (fALFF) in the anterior insula (pheight < .005). Conclusions The results underscore the importance of emotions in moral cognition and suggest a common basis for deficits in both abilities, possibly related to reduced experience of emotional sensations. At the neural level abnormal moral cognition in bvFTD is related to structural integrity of the medial prefrontal cortex and functional characteristics of the anterior insula. The present findings provide a common basis for emotion recognition and moral reasoning and link them with areas in the default mode and salience network.
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Affiliation(s)
- Jan Van den Stock
- Laboratory for Translational NeuropsychiatryDepartment of NeurosciencesKU LeuvenLeuvenBelgium
- Department of Old Age PsychiatryUniversity Psychiatry CenterLeuvenBelgium
| | - Daphne Stam
- Laboratory for Translational NeuropsychiatryDepartment of NeurosciencesKU LeuvenLeuvenBelgium
| | - François‐Laurent De Winter
- Laboratory for Translational NeuropsychiatryDepartment of NeurosciencesKU LeuvenLeuvenBelgium
- Department of Old Age PsychiatryUniversity Psychiatry CenterLeuvenBelgium
| | - Dante Mantini
- Research Center for Movement Control and NeuroplasticityKU LeuvenLeuvenBelgium
- Department of Health Sciences and TechnologyETH ZurichZurichSwitzerland
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | | | - Koen Van Laere
- Nuclear Medicine and Molecular ImagingDepartment of Imaging and PathologyKU LeuvenLeuvenBelgium
| | - Rik Vandenberghe
- Laboratory for Cognitive NeurologyDepartment of NeurosciencesKU LeuvenLeuvenBelgium
- Department of NeurologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Mathieu Vandenbulcke
- Laboratory for Translational NeuropsychiatryDepartment of NeurosciencesKU LeuvenLeuvenBelgium
- Department of Old Age PsychiatryUniversity Psychiatry CenterLeuvenBelgium
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12
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Birkhoff JM, Garberi C, Re L. The behavioral variant of frontotemporal dementia: An analysis of the literature and a case report. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 47:157-163. [PMID: 27143117 DOI: 10.1016/j.ijlp.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
The aim of this case report is to underline the importance of possible legal consequences of the behavioral variant of frontotemporal dementia (bvFTD). This disease is associated with antisocial behavior, impulse control disorder and cognitive and personality impairment, which are often the earliest manifestations of the bvFTD. One of the antisocial behaviors possibly associated with this neurodegenerative disease is pathological stealing. This case report is about a 50-year-old Italian man who had a regular life until 2010. In 2010 and 2011, some critical events occurred: he lost his job, his father-in-law, to whom he was particularly close, died, and his wife had a serious illness. He began to show symptoms of depression, a significant weight loss, apathy, poor self-care, and lack of interest in the activities of his family. He became disengaged from his prior activities, emotionally detached from his family and developed compulsive hoarding. Moreover, he had uninhibited behaviors, a memory retrieval deficit, executive dysfunctions and impulsive behaviors. In January 2012, the subject began stealing objects, particularly components of computer, without premeditation or concern for resulting legal actions. He was then diagnosed affected by bvFTD. He was charged with theft and attempted theft and the Court asked for a psychiatric evaluation, in order to analyze the effect of the neurodegenerative disease on his behavior. To answer to the Court, the Authors analyzed his history of life and made a mental examination. The subject was considered mentally insane at the time of his crimes. This is an example of the practical application in judicial cases of the latest knowledge and evidence in the literature about the frontotemporal dementia, a disease associated with antisocial behaviors that could create tensions with the criminal law. The focus of the paper is to explain how the behavioral symptoms of bvFTD can have legal implications and how to deal with legal aspects of the behaviors induced by a neuro-psychiatric condition, such as bvFTD.
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Affiliation(s)
- Jutta Maria Birkhoff
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy
| | - Cesare Garberi
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy
| | - Laura Re
- Department of Biotechnologies and Life Sciences, University of Insubria, Varese-Como, Italy.
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Berryessa CM. Behavioral and neural impairments of frontotemporal dementia: Potential implications for criminal responsibility and sentencing. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 46:1-6. [PMID: 27039661 DOI: 10.1016/j.ijlp.2016.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Individuals in the early stages of the behavioral variant of frontotemporal dementia (bvFTD), a progressive neurodegenerative disorder marked by atrophy to the brain's frontal regions, exhibit severe disturbances to social and moral processing and decision-making after the onset of the disorder. These behavioral impairments, underlain by the neural deficits associated with the disorder, can often lead individuals with bvFTD to criminally offend. As such, behavioral and frontotemporal lobe abnormalities exhibited by offenders with bvFTD potentially represent several complex challenges for the legal system. This paper examines some of the ways in which the behavioral and neural impairments associated with bvFTD may influence issues surrounding the criminal responsibility, specifically legal insanity, and sentencing of offenders with bvFTD in the U.S. legal system. As there is very little literature in these areas concerning bvFTD, the existing academic dialogue on psychopathy, a disorder with similar behavioral symptoms and neural deficits, is used to frame the discussion on these issues.
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Affiliation(s)
- Colleen M Berryessa
- Department of Criminology, University of Pennsylvania, 483 McNeil Building, 3718 Locust Walk, Philadelphia, PA 19104, USA.
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14
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Baez S, Morales JP, Slachevsky A, Torralva T, Matus C, Manes F, Ibanez A. Orbitofrontal and limbic signatures of empathic concern and intentional harm in the behavioral variant frontotemporal dementia. Cortex 2015; 75:20-32. [PMID: 26707083 DOI: 10.1016/j.cortex.2015.11.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/28/2015] [Accepted: 11/12/2015] [Indexed: 01/10/2023]
Abstract
Perceiving and evaluating intentional harms in an interpersonal context engages both cognitive and emotional domains. This process involves inference of intentions, moral judgment, and, crucially, empathy towards others' suffering. This latter skill is notably impaired in behavioral variant frontotemporal dementia (bvFTD). However, the relationship between regional brain atrophy in bvFTD and deficits in the above-mentioned abilities is not well understood. The present study investigated how gray matter (GM) atrophy in bvFTD patients correlates with the perception and evaluation of harmful actions (attribution of intentionality, evaluation of harmful behavior, empathic concern, and moral judgment). First, we compared the behavioral performance of 26 bvFTD patients and 23 healthy controls on an experimental task (ET) indexing intentionality, empathy, and moral cognition during evaluation of harmful actions. Second, we compared GM volume in patients and controls using voxel-based morphometry (VBM). Third, we examined brain regions where atrophy might be associated with specific impairments in the patient group. Finally, we explored whether the patients' deficits in intentionality comprehension and empathic concern could be partially explained by regional GM atrophy or impairments in other relevant factors, such as executive functions (EFs). In bvFTD patients, atrophy of limbic structures (amygdala and anterior paracingulate cortex--APC) was related to impairments in intentionality comprehension, while atrophy of the orbitofrontal cortex (OFC) was associated with empathic concern deficits. Intentionality comprehension impairments were predicted by EFs and orbitofrontal atrophy predicted deficits in empathic concern. Thus, although the perception and evaluation of harmful actions are variously compromised in bvFTD, deficits in empathic concern may be central to this syndrome as they are associated with one of the earliest atrophied region. More generally, our results shed light on social cognition deficits in bvFTD and may have important clinical implications.
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Affiliation(s)
- Sandra Baez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina.
| | - Juan P Morales
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile.
| | - Andrea Slachevsky
- Departamento de Fisiopatología, ICBM y Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Unidad de Neurología Cognitiva y Demencias, Departamento de Neurología Oriente, Facultad de Medicina, Universidad de Chile y Servicio de Neurología, Hospital del Salvador, Santiago, Chile; Centro de Investigación Avanzada en Educación, Universidad de Chile, Santiago, Chile; Servicio de Neurología, Clínica Alemana, Santiago, Chile.
| | - Teresa Torralva
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile.
| | - Cristian Matus
- Fundación Médica San Cristobal, Santiago, Chile; Hospital de Carabineros de Chile, Santiago, Chile.
| | - Facundo Manes
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina; ACR Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia.
| | - Agustin Ibanez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro University, Buenos Aires, Argentina; UDP-INECO Foundation Core on Neuroscience (UIFCoN), Faculty of Psychology, Diego Portales University, Santiago, Chile; National Scientific and Technical Research Council (CONICET), Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; ACR Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia.
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15
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Affective mentalizing and brain activity at rest in the behavioral variant of frontotemporal dementia. NEUROIMAGE-CLINICAL 2015; 9:484-97. [PMID: 26594631 PMCID: PMC4600858 DOI: 10.1016/j.nicl.2015.08.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 12/13/2022]
Abstract
Background bvFTD patients display an impairment in the attribution of cognitive and affective states to others, reflecting GM atrophy in brain regions associated with social cognition, such as amygdala, superior temporal cortex and posterior insula. Distinctive patterns of abnormal brain functioning at rest have been reported in bvFTD, but their relationship with defective attribution of affective states has not been investigated. Objective To investigate the relationship among resting-state brain activity, gray matter (GM) atrophy and the attribution of mental states in the behavioral variant of fronto-temporal degeneration (bvFTD). Methods We compared 12 bvFTD patients with 30 age- and education-matched healthy controls on a) performance in a task requiring the attribution of affective vs. cognitive mental states; b) metrics of resting-state activity in known functional networks; and c) the relationship between task-performances and resting-state metrics. In addition, we assessed a connection between abnormal resting-state metrics and GM atrophy. Results Compared with controls, bvFTD patients showed a reduction of intra-network coherent activity in several components, as well as decreased strength of activation in networks related to attentional processing. Anomalous resting-state activity involved networks which also displayed a significant reduction of GM density. In patients, compared with controls, higher affective mentalizing performance correlated with stronger functional connectivity between medial prefrontal sectors of the default-mode and attentional/performance monitoring networks, as well as with increased coherent activity in components of the executive, sensorimotor and fronto-limbic networks. Conclusions Some of the observed effects may reflect specific compensatory mechanisms for the atrophic changes involving regions in charge of affective mentalizing. The analysis of specific resting-state networks thus highlights an intermediate level of analysis between abnormal brain structure and impaired behavioral performance in bvFTD, reflecting both dysfunction and compensation mechanisms. bvFTD patients are impaired in the attribution of mental states to others (theory of mind, ToM). bvFTD patients' ToM deficit involves mainly the attribution of affective states. Affective ToM deficits in bvFTD reflect gray matter atrophy in frontolimbic areas. Affective ToM deficits in bvFTD reflect altered frontomedial resting-state activity. Brain activity at rest reflects both dysfunction and compensation mechanisms in bvFTD.
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Key Words
- AD, Alzheimer's disease
- Affective mentalizing
- BOLD, blood-oxygen-level-dependent
- Behavioral variant of frontotemporal dementia
- CI, causal inferences
- Default mode network
- EA, emotion attribution
- Executive functioning network
- FDR, false discovery rate
- FTLD, frontotemporal lobar degeneration
- GM, gray matter
- IA, intention attribution
- MANCOVAN, multivariate analysis of covariance
- MMSE, Mini-Mental State Examination
- PCA, principal component analysis
- RSNs, resting-state networks
- Resting state functional MRI
- SET, story-based empathy task
- SPM, statistical parametric mapping
- ToM, theory of mind
- VBM, voxel based morphometry
- aDMN, anterior default mode network
- bvFTD, behavioral variant of frontotemporal dementia
- gICA, group independent component analysis
- pDMN, posterior default mode network
- rs-fMRI, resting-state fMRI
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16
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Baez S, Manes F, Huepe D, Torralva T, Fiorentino N, Richter F, Huepe-Artigas D, Ferrari J, Montañes P, Reyes P, Matallana D, Vigliecca NS, Decety J, Ibanez A. Primary empathy deficits in frontotemporal dementia. Front Aging Neurosci 2014; 6:262. [PMID: 25346685 PMCID: PMC4193328 DOI: 10.3389/fnagi.2014.00262] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/11/2014] [Indexed: 01/10/2023] Open
Abstract
Loss of empathy is an early central symptom and diagnostic criterion of the behavioral variant frontotemporal dementia (bvFTD). Although changes in empathy are evident and strongly affect the social functioning of bvFTD patients, few studies have directly investigated this issue by means of experimental paradigms. The current study assessed multiple components of empathy (affective, cognitive and moral) in bvFTD patients. We also explored whether the loss of empathy constitutes a primary deficit of bvFTD or whether it is explained by impairments in executive functions (EF) or other social cognition domains. Thirty-seven bvFTD patients with early/mild stages of the disease and 30 healthy control participants were assessed with a task that involves the perception of intentional and accidental harm. Participants were also evaluated on emotion recognition, theory of mind (ToM), social norms knowledge and several EF domains. BvFTD patients presented deficits in affective, cognitive and moral aspects of empathy. However, empathic concern was the only aspect primarily affected in bvFTD that was neither related nor explained by deficits in EF or other social cognition domains. Deficits in the cognitive and moral aspects of empathy seem to depend on EF, emotion recognition and ToM. Our findings highlight the importance of using tasks depicting real-life social scenarios because of their greater sensitivity in the assessment of bvFTD. Moreover, our results contribute to the understanding of primary and intrinsic empathy deficits of bvFTD and have important theoretical and clinical implications.
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Affiliation(s)
- Sandra Baez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
- National Scientific and Technical Research Council (CONICET)Buenos Aires, Argentina
| | - Facundo Manes
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
- National Scientific and Technical Research Council (CONICET)Buenos Aires, Argentina
- Australian Research Council (ACR) Centre of Excellence in Cognition and its DisordersSydney, NSW, Australia
| | - David Huepe
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
- Laboratory of Cognitive and Social Neuroscience, Universidad Diego PortalesSantiago, Chile
| | - Teresa Torralva
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
| | - Natalia Fiorentino
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
| | - Fabian Richter
- Department of Psychology, University of CologneCologne, Germany
| | - Daniela Huepe-Artigas
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
- Laboratory of Cognitive and Social Neuroscience, Universidad Diego PortalesSantiago, Chile
| | - Jesica Ferrari
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
| | - Patricia Montañes
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Centro de Memoria y Cognición Intellectus, Instituto de Envejecimiento, Universidad Javeriana, Hospital San IgnacioBogotá, Colombia
- Universidad Nacional de ColombiaBogotá, Colombia
| | - Pablo Reyes
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Centro de Memoria y Cognición Intellectus, Instituto de Envejecimiento, Universidad Javeriana, Hospital San IgnacioBogotá, Colombia
| | - Diana Matallana
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Centro de Memoria y Cognición Intellectus, Instituto de Envejecimiento, Universidad Javeriana, Hospital San IgnacioBogotá, Colombia
| | - Nora S. Vigliecca
- National Scientific and Technical Research Council (CONICET)Buenos Aires, Argentina
- Instituto de Humanidades (IDH) de la Facultad de Filosofía y Humanidades, Universidad Nacional de CórdobaCórdoba, Argentina
| | - Jean Decety
- Department of Psychology and Department of Psychiatry and Behavioral Neuroscience, University of ChicagoChicago, IL, USA
| | - Agustin Ibanez
- Institute of Cognitive Neurology (INECO) & Institute of Neuroscience, Favaloro UniversityBuenos Aires, Argentina
- UDP-INECO Foundation Core on Neuroscience (UIFCoN), Diego Portales UniversitySantiago, Chile
- National Scientific and Technical Research Council (CONICET)Buenos Aires, Argentina
- Australian Research Council (ACR) Centre of Excellence in Cognition and its DisordersSydney, NSW, Australia
- Universidad Autonoma del CaribeBarranquilla, Colombia
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17
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Filippi M, Agosta F, Scola E, Canu E, Magnani G, Marcone A, Valsasina P, Caso F, Copetti M, Comi G, Cappa SF, Falini A. Functional network connectivity in the behavioral variant of frontotemporal dementia. Cortex 2013; 49:2389-401. [DOI: 10.1016/j.cortex.2012.09.017] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 06/27/2012] [Accepted: 09/28/2012] [Indexed: 10/27/2022]
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18
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Pascual L, Rodrigues P, Gallardo-Pujol D. How does morality work in the brain? A functional and structural perspective of moral behavior. Front Integr Neurosci 2013; 7:65. [PMID: 24062650 PMCID: PMC3770908 DOI: 10.3389/fnint.2013.00065] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 08/10/2013] [Indexed: 11/24/2022] Open
Abstract
Neural underpinnings of morality are not yet well understood. Researchers in moral neuroscience have tried to find specific structures and processes that shed light on how morality works. Here, we review the main brain areas that have been associated with morality at both structural and functional levels and speculate about how it can be studied. Orbital and ventromedial prefrontal cortices are implicated in emotionally-driven moral decisions, while dorsolateral prefrontal cortex appears to moderate its response. These competing processes may be mediated by the anterior cingulate cortex. Parietal and temporal structures play important roles in the attribution of others' beliefs and intentions. The insular cortex is engaged during empathic processes. Other regions seem to play a more complementary role in morality. Morality is supported not by a single brain circuitry or structure, but by several circuits overlapping with other complex processes. The identification of the core features of morality and moral-related processes is needed. Neuroscience can provide meaningful insights in order to delineate the boundaries of morality in conjunction with moral psychology.
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Affiliation(s)
- Leo Pascual
- Department of Personality, University of BarcelonaBarcelona, Spain
| | - Paulo Rodrigues
- Department of Personality, University of BarcelonaBarcelona, Spain
- Mint Labs S.L.Barcelona, Spain
| | - David Gallardo-Pujol
- Department of Personality, University of BarcelonaBarcelona, Spain
- Institute for Brain, Cognition, and Behavior (IR3C), Universitat de BarcelonaBarcelona, Spain
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Gleichgerrcht E, Torralva T, Rattazzi A, Marenco V, Roca M, Manes F. Selective impairment of cognitive empathy for moral judgment in adults with high functioning autism. Soc Cogn Affect Neurosci 2012; 8:780-8. [PMID: 22689217 DOI: 10.1093/scan/nss067] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Faced with a moral dilemma, conflict arises between a cognitive controlled response aimed at maximizing welfare, i.e. the utilitarian judgment, and an emotional aversion to harm, i.e. the deontological judgment. In the present study, we investigated moral judgment in adult individuals with high functioning autism/Asperger syndrome (HFA/AS), a clinical population characterized by impairments in prosocial emotions and social cognition. In Experiment 1, we compared the response patterns of HFA/AS participants and neurotypical controls to moral dilemmas with low and high emotional saliency. We found that HFA/AS participants more frequently delivered the utilitarian judgment. Their perception of appropriateness of moral transgression was similar to that of controls, but HFA/AS participants reported decreased levels of emotional reaction to the dilemma. In Experiment 2, we explored the way in which demographic, clinical and social cognition variables including emotional and cognitive aspects of empathy and theory of mind influenced moral judgment. We found that utilitarian HFA/AS participants showed a decreased ability to infer other people's thoughts and to understand their intentions, as measured both by performance on neuropsychological tests and through dispositional measures. We conclude that greater prevalence of utilitarianism in HFA/AS is associated with difficulties in specific aspects of social cognition.
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20
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Abstract
Converging evidence suggests that when individuals are left to think to themselves, a so-called default network of the brain is engaged, allowing the individual to daydream, reflect on their past, imagine possible future scenarios, and consider the viewpoints of others. These flexible self-relevant mental explorations enable the anticipation and evaluation of events before they occur, and are essential for successful social interactions. Such self-projective efforts are particularly vulnerable to disruption in frontotemporal dementia (FTD), a neurodegenerative disorder involving damage to the frontal and temporal lobes of the brain. In this Review, we explore how the progressive degeneration of the neural networks in two subtypes of FTD-the behavioral variant and semantic dementia-affects key structures of the default network and putative self-projective functions. We examine the available evidence from studies of autobiographical memory, episodic future thinking, theory of mind, moral reasoning, and economic decision-making in these neurodegenerative diseases. Finally, we propose that the mapping of default-network functions onto discrete subsystems of the default network may need revision in light of neuropsychological and clinical evidence from studies in patients with FTD.
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21
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Manes F, Torralva T, Ibáñez A, Roca M, Bekinschtein T, Gleichgerrcht E. Decision-making in frontotemporal dementia: clinical, theoretical and legal implications. Dement Geriatr Cogn Disord 2012; 32:11-7. [PMID: 21822019 DOI: 10.1159/000329912] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. METHODS The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. RESULTS Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. CONCLUSIONS Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'.
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Affiliation(s)
- Facundo Manes
- Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina. fmanes @ ineco.org.ar
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22
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Basile B, Mancini F, Macaluso E, Caltagirone C, Frackowiak RSJ, Bozzali M. Deontological and altruistic guilt: evidence for distinct neurobiological substrates. Hum Brain Mapp 2011; 32:229-39. [PMID: 20842749 DOI: 10.1002/hbm.21009] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The feeling of guilt is a complex mental state underlying several human behaviors in both private and social life. From a psychological and evolutionary viewpoint, guilt is an emotional and cognitive function, characterized by prosocial sentiments, entailing specific moral believes, which can be predominantly driven by inner values (deontological guilt) or by more interpersonal situations (altruistic guilt). The aim of this study was to investigate whether there is a distinct neurobiological substrate for these two expressions of guilt in healthy individuals. We first run two behavioral studies, recruiting a sample of 72 healthy volunteers, to validate a set of stimuli selectively evoking deontological and altruistic guilt, or basic control emotions (i.e., anger and sadness). Similar stimuli were reproduced in a event-related functional magnetic resonance imaging (fMRI) paradigm, to investigate the neural correlates of the same emotions, in a new sample of 22 healthy volunteers. We show that guilty emotions, compared to anger and sadness, activate specific brain areas (i.e., cingulate gyrus and medial frontal cortex) and that different neuronal networks are involved in each specific kind of guilt, with the insula selectively responding to deontological guilt stimuli. This study provides evidence for the existence of distinct neural circuits involved in different guilty feelings. This complex emotion might account for normal individual attitudes and deviant social behaviors. Moreover, an abnormal processing of specific guilt feelings might account for some psychopathological manifestation, such as obsessive-compulsive disorder and depression.
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Affiliation(s)
- Barbara Basile
- Neuroimaging Laboratory, Santa Lucia Foundation, IRCCS, Rome, Italy
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23
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The false memory syndrome: experimental studies and comparison to confabulations. Med Hypotheses 2010; 76:492-6. [PMID: 21177042 DOI: 10.1016/j.mehy.2010.11.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 11/22/2010] [Accepted: 11/26/2010] [Indexed: 11/21/2022]
Abstract
False memories, or recollections that are factually incorrect but strongly believed, remain a source of confusion for both psychiatrists and neurologists. We propose model for false memories based on recent experimental investigations, particularly when analyzed in comparison to confabulations, which are the equivalent of false memories from neurological disease. Studies using the Deese/Roedinger-McDermott experimental paradigm indicate that false memories are associated with the need for complete and integrated memories, self-relevancy, imagination and wish fulfillment, familiarity, emotional facilitation, suggestibility, and sexual content. In comparison, confabulations are associated with the same factors except for emotional facilitation, suggestibility, and sexual content. Both false memories and confabulations have an abnormal sense of certainty for their recollections, and neuroanatomical findings implicate decreased activity in the ventromedial frontal lobe in this certainty. In summary, recent studies of false memories in comparison to confabulations support a model of false memories as internally-generated but suggestible and emotionally-facilitated fantasies or impulses, rather than repressed memories of real events. Furthermore, like confabulations, in order for false memories to occur there must be an attenuation of the normal, nonconscious, right frontal "doubt tag" regarding their certainty.
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Moll J, Zahn R, de Oliveira-Souza R, Bramati IE, Krueger F, Tura B, Cavanagh AL, Grafman J. Impairment of prosocial sentiments is associated with frontopolar and septal damage in frontotemporal dementia. Neuroimage 2010; 54:1735-42. [PMID: 20728544 DOI: 10.1016/j.neuroimage.2010.08.026] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 08/11/2010] [Accepted: 08/13/2010] [Indexed: 12/16/2022] Open
Abstract
Poets and philosophers have long acknowledged moral sentiments as key motivators of human social behavior. Prosocial sentiments, which include guilt, pity and embarrassment, enable us to care about others and to be concerned about our mistakes. Functional imaging studies have implicated frontopolar, ventromedial frontal and basal forebrain regions in the experience of prosocial sentiments. Patients with lesions of the frontopolar and ventromedial frontal areas were observed to behave inappropriately and less prosocially, which could be attributed to a generalized emotional blunting. Direct experimental evidence for brain regions distinctively associated with moral sentiment impairments is lacking, however. We investigated this issue in patients with the behavioral variant of frontotemporal dementia, a disorder in which early and selective impairments of social conduct are consistently observed. Using a novel moral sentiment task, we show that the degree of impairment of prosocial sentiments is associated with the degree of damage to frontopolar cortex and septal area, as assessed with 18-Fluoro-Deoxy-Glucose-Positron Emission Tomography, an established measure of neurodegenerative damage. This effect was dissociable from impairment of other-critical feelings (anger and disgust), which was in turn associated with dorsomedial prefrontal and amygdala dysfunction. Our findings suggest a critical role of the frontopolar cortex and septal region in enabling prosocial sentiments, a fundamental component of moral conscience.
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Affiliation(s)
- Jorge Moll
- Cognitive Neuroscience Section, NINDS, National Institutes of Health, Bethesda, MD 20892-1440, USA
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Gleichgerrcht E, Torralva T, Roca M, Pose M, Manes F. The role of social cognition in moral judgment in frontotemporal dementia. Soc Neurosci 2010; 6:113-22. [PMID: 20706963 DOI: 10.1080/17470919.2010.506751] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Patients with behavioral variant frontotemporal dementia (bvFTD) exhibit a set of behavioral disturbances that have been strongly associated with involvement of the prefrontal cortex (PFC). Many such disturbances have been linked to impaired moral behavior, especially in regard to "personal" or "emotionally driven" moral dilemmatic judgment, which has been demonstrated to also depend on the integrity of the PFC. In this study, we administered a personal moral dilemma (the footbridge dilemma) and social cognition measures to patients with early bvFTD, who were also assessed with an extensive neuropsychological battery, including moral knowledge, cognitive and emotional empathy, and affective decision-making. BvFTD patients who would push a man off a footbridge (knowing this would kill him) to save the life of five workers who would have been otherwise killed by the train showed significantly lower scores on affective Theory of Mind (ToM) relative to those bvFTD patients who responded negatively. No significant differences were found on other sociodemographic, neuropsychological or social cognition variables. This study reveals that altered dilemmatic judgment may be related to impaired affective ToM, which has important clinical and theoretical implications.
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Cannas A, Solla P, Floris GL, Serra C, Costantino E, Piras V, Marrosu F, Marrosu MG. Dopaminergic drugs, paraphilic fantasies, paraphilic behaviours and creativity in Parkinson's disease. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:563-4. [PMID: 20153398 DOI: 10.1016/j.pnpbp.2010.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 02/08/2010] [Indexed: 10/19/2022]
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de Oliveira-Souza R, Moll J. The neural bases of normal and deviant moral cognition and behavior. Top Magn Reson Imaging 2009; 20:261-270. [PMID: 20859187 DOI: 10.1097/rmr.0b013e3181f22f69] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Ricardo de Oliveira-Souza
- Cognitive and Behavioral Neuroscience Unit, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil
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Gericke GS. Does HIV-1/AIDS-associated frontotemporal neuropathology following perinatal infection influence the development of moral behaviour? Med Hypotheses 2008; 70:1139-46. [PMID: 18255237 DOI: 10.1016/j.mehy.2006.05.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2006] [Accepted: 05/23/2006] [Indexed: 11/16/2022]
Abstract
While HIV encephalopathy and the AIDS dementia complex are considered hallmark neurologic manifestations of HIV-1 infection, increasing evidence of a continuum of nervous system involvement indicates the existence of an unrecognized number of individuals with milder, mostly cognitive and/or behavioural effects. Questions are raised whether HIV-related frontotemporal neuropathology during critical developmental stages could affect development of the brain networks documented to be involved in moral decisions, and whether this could contribute to the phenomenon of delinquency in an unknown percentage of the current generation of approximately 18-25 year old survivors of early childhood or vertically acquired HIV infection. Carefully planned and executed long term, prospective controlled studies using environmental, clinical, neurological, behavioural, genetic, immune and functional neuroimaging correlates would be required to elucidate whether HIV-specific neuropathology could indeed act as an independent risk factor for the development of a frontotemporal sociopathy syndrome. If such an association is proven, the accelerated development of neurospecific therapies should be a priority, especially for clinically and immunologically stable HIV-infected children. It may be necessary to institute such treatment as early as possible in perinatally infected cases, and maybe even during intrauterine life if HIV-1 is demonstrated to also act as a neurobehavioural teratogen for the developing fetal brain. It may, however, prove to be difficult to separate primary neurobiological from environmental factors, since the epigenetic effects on the host genome of retroviral insertion influencing behavioural gene expression characteristics, and altered gene expression following early life stresses may involve overlapping neurodevelopmental gene regulatory networks. In the meantime it remains necessary to prevent or ameliorate frequent neuropsychiatric morbidity from whatever causes.
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Affiliation(s)
- G S Gericke
- Department of Biomedical Sciences, Tshwane University of Technology, PO Box 2040, Brooklyn Square, 0075 Pretoria, Gauteng, South Africa.
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Foster JA, MacQueen G. Neurobiological factors linking personality traits and major depression. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2008; 53:6-13. [PMID: 18286867 DOI: 10.1177/070674370805300103] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine the neurobiological basis of personality and depression. METHOD We examined preclinical and clinical studies related to neuroanatomy, neuroendocrine, molecular, and genetic alterations in depressed patients. We considered whether common neurobiological factors might be shared between personality and depression. RESULTS Preclinical studies provide insights into the neurobiological mechanisms underlying the pathophysiology of depression including neuroendocrine alterations in hypothalamic-pituitary-adrenal (HPA) function, neuroanatomical alterations in key brain regions, and alterations in neurotrophin and serotonergic signalling systems. Clinical studies show similar alterations in depressed patients. Evidence suggests that neuroendocrine alterations in HPA function may contribute to personality traits. Brain regions implicated in depression, including the hippocampus and the anterior cingulate cortex, might play a role in personality. Key molecules implicated in depression have been extensively studied with reference to personality traits, particularly neuroticism. To date, physiological measures (serum and positron emission tomography) provide the strongest evidence implicating brain-derived neurotrophic factor and serotonin in personality, while genetic evidence is less convincing. CONCLUSIONS A neurobiological link exists between personality and depression; however, more work is needed to provide an understanding of the nature of this relation and to link this work with clinical studies examining the influence of personality factors on depression.
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Affiliation(s)
- Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University
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Schroeter ML, Raczka K, Neumann J, Yves von Cramon D. Towards a nosology for frontotemporal lobar degenerations—A meta-analysis involving 267 subjects. Neuroimage 2007; 36:497-510. [PMID: 17478101 DOI: 10.1016/j.neuroimage.2007.03.024] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 02/20/2007] [Accepted: 03/14/2007] [Indexed: 12/12/2022] Open
Abstract
Frontotemporal lobar degeneration is the second most common diagnosis of dementia in individuals younger than 65 years. We conducted a systematic and quantitative meta-analysis to examine neural correlates of frontotemporal lobar degeneration and its subtypes and to place the disease in a framework of cognitive neuropsychiatry. MedLine and Current Contents search engines were used to identify functional and anatomical imaging studies investigating frontotemporal lobar degeneration between 1980 and 2005. Studies were included, if they were peer-reviewed, applied internationally recognized diagnostic criteria, were original studies, and had results normalized to a stereotactic space. 19 studies were identified reporting either atrophy or decreases in glucose utilization. Finally, the analysis involved 267 subjects suffering from frontotemporal lobar degeneration and 351 control subjects. A quantitative meta-analysis was performed. Maxima of the studies resulted in activation likelihood estimates. The meta-analysis revealed specific neural networks for each of the three clinically defined subtypes of frontotemporal lobar degeneration, namely frontotemporal dementia, semantic dementia, and progressive non-fluent aphasia. Networks did not overlap as shown by a conjunction analysis, and they corresponded to clinical characteristics. The study relates the clinical features of each subtype of frontotemporal lobar degeneration specifically to its neural substrate. By 'triple dissociating' frontotemporal lobar degenerations into three clinicoanatomical prototypes, the study contributes to placing these disorders in cognitive neuropsychiatry and suggests a respective nosology.
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Affiliation(s)
- Matthias L Schroeter
- Max-Planck-Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany.
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Weder ND, Aziz R, Wilkins K, Tampi RR. Frontotemporal dementias: a review. Ann Gen Psychiatry 2007; 6:15. [PMID: 17565679 PMCID: PMC1906781 DOI: 10.1186/1744-859x-6-15] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 06/12/2007] [Indexed: 12/12/2022] Open
Abstract
Dementia is a clinical state characterized by loss of function in multiple cognitive domains. It is a costly disease in terms of both personal suffering and economic loss. Frontotemporal dementia (FTD) is the term now preferred over Picks disease to describe the spectrum of non-Alzheimers dementias characterized by focal atrophy of the frontal and anterior temporal regions of the brain. The prevalence of FTD is considerable, though specific figures vary among different studies. It occurs usually in an age range of 35-75 and it is more common in individuals with a positive family history of dementia. The risk factors associated with this disorder include head injury and family history of FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, the three major clinical presentations of FTD include: 1) a frontal or behavioral variant (FvFTD), 2) a temporal, aphasic variant, also called Semantic dementia (SD), and 3) a progressive aphasia (PA). These different variants differ in their clinical presentation, cognitive deficits, and affected brain regions. Patients with FTD should have a neuropsychiatric assessment, neuropsychological testing and neuroimaging studies to confirm and clarify the diagnosis. Treatment for this entity consists of behavioral and pharmacological approaches. Medications such as serotonin reuptake inhibitors, antipsychotics, mood stabilizer and other novel treatments have been used in FTD with different rates of success. Further research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the patients' prognosis and quality of life.
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Affiliation(s)
- Natalie D Weder
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rehan Aziz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Kirsten Wilkins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajesh R Tampi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Schroeter ML, Raczka K, Neumann J, von Cramon DY. Neural networks in frontotemporal dementia--a meta-analysis. Neurobiol Aging 2006; 29:418-26. [PMID: 17140704 DOI: 10.1016/j.neurobiolaging.2006.10.023] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 08/27/2006] [Accepted: 10/18/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Frontotemporal dementia is the most common form of frontotemporal lobar degeneration. It is characterized by deep alterations in behavior and personality. We conducted a systematic and quantitative meta-analysis to examine its neural correlates and place the disease in a framework of cognitive neuropsychiatry. METHODS MedLine and Current Contents search engines were used to identify imaging studies investigating frontotemporal dementia between 1980 and 2005. Nine studies were identified reporting either atrophy or decreases in glucose utilization. Finally, the analysis involved 132 patients and 166 controls. A quantitative meta-analysis was performed. Maxima of the studies resulted in activation likelihood estimates. RESULTS The meta-analysis revealed a particularly frontomedian network impaired in frontotemporal dementia. Additionally, right anterior insula, and medial thalamus were identified. CONCLUSIONS Our study specifies frontotemporal dementia as the frontomedian variant of frontotemporal lobar degeneration. The disease affects neural networks enabling self-monitoring, theory of mind capabilities, processing/evaluation of internal mental states, perception of pain and emotions, and sustaining personality and self. Our study contributes to placing frontotemporal dementia in cognitive neuropsychiatry.
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Affiliation(s)
- Matthias L Schroeter
- Max-Planck-Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany.
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